Transummhilical laparoscopic cholecystectomy with improved instruments

Abstract

Objective The major barrier to transumbilical endoscopic surgery is from external interference between the instruments handles around the umbilicus. We describe the technique of totally transumbilical endoscopic cholecystectomy by using improved instruments. Methods 54 cases of transumbilical laparoscopic cholecystectomy were performed with improved instruments in patients with gallbladder polyps (13 cases) and gallstones (41 cases). The new trocars without the proximal seal system on the sleeves were designed for this procedure. The instruments used in this study were 5 cm longer than commercially available ones. Results All the gallbladders were removed successfully without severe intraoperative bleeding during and postoperative complications. Mean operating time was 25-56 min (average 34±28 min). All the patients were satisfied with the abdominal cosmetic results, discharged 48 h after the operations, and returned to work within seven postoperative days.Conclusions The external interference between trocars and instruments can be partially avoided by using the improved instruments. Totally transumbilical laparoscopic cholecystectomy becomes feasible by this technique. Key words: Endoscopy; Transumbilical; Surgery; Cholecystectomy; TUES